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Puxitatug samrotecan is a novel antibody-drug conjugate (ADC) developed by AstraZeneca for the treatment of advanced or metastatic solid tumors. It consists of a monoclonal antibody targeting B7-H4 (V-set domain containing T cell activation inhibitor 1, also known as VTCN1), an immunoregulatory protein highly expressed in several solid tumors but with limited expression in normal tissues. The ADC is conjugated to a topoisomerase I inhibitor payload (samrotecan, also referred to as AZ14170133), which disrupts DNA replication and induces tumor cell death upon internalization. Puxitatug samrotecan has demonstrated promising efficacy and manageable safety in phase 1/2 trials, particularly in gynecologic cancers such as endometrial and ovarian cancer, as well as breast and biliary tract cancers. The drug is administered intravenously.
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